EHRs Rush in Where Doctors Fear to Tread

Scott Mace, for HealthLeaders Media , March 21, 2013

"Then they usually have to go back and retrain and relearn, because they were more worried about just keeping the patient flow going than they were learning a new tool," Best says.

Leadership has to do its part, selling the transition to EHRs as hard as any sales job, says Kshitij Saxena, MD, medical director of medical informatics at Adventist Health System, a 31-hospital organization based in Altamonte Springs, Fla., which spans 12 states in the South and Midwest.

"You have to go and tell it to them in front of hundreds of doctors who are ready to kill you," Saxena says. "You go and give them the benefits. You go and tell them the negative side of it as well. You tell them up front, the first three weeks there will be yelling and screaming. Please be prepared. And then you tell them the ways where the pain can be minimized."

Buy-in from the rest of the C-suite is essential, Saxena says. "You make the training mandatory. You would never sit on a plane that was being flown by an untrained pilot, right? Same goes for the doctors. The ones who do not know how to deliver safe patient care, do not know how to use systems so that there can be no safety issues, they shouldn't be allowed to practice," he says, suggesting an analogy to board certification.

It's also essential to have physicians engaged during the design phase. But how do you get these busy professionals to take time out of their practices to do so? Saxena's answer: You pay them for the time it takes to get them, and the EHR, up to speed.

"I would prefer to bring in those physicians, get their input at the time of design, and make them the physician champions at the time of go-live instead of bringing 100 people from the vendor at the time of go-live," Saxena says.

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